Australia was supposed to be just days away from its first free pill testing trial. Using either a small scrape or the entirety of a pill, the controversial proposal was designed to test the quality of illicit drugs in just minutes. The ACT government had allowed the testing, to be conducted by Harm Reduction Australia, at Canberra’s Spilt Milk festival.

The ACT government’s public comments were suitably cautious for such a controversial issue, making clear that it did not condone drug use and the trial was based on safety. ‘Pill testing means young people who are considering taking drugs can be informed about what’s really in their pills and how potent they are,’ ACT Health Minister Meegan Fitzharris said.

But something went wrong. The trial was cancelled following a dispute about whether territory or federal authorities were responsible. (A pill testing trial was also denied for the Groove in the Moo festival earlier this year.)

Supporters of pill testing say that it reduces harm and saves lives. Opponents say it condones drug use and puts society on a slippery slope to decriminalisation or legalisation of illicit drugs. In the middle are the politicians, police and other authorities – concerned about reducing harm, but charged with making and enforcing the law.

Late last month, Victorian Premier Daniel Andrews had a change of heart and announced a two year trial of a safe injecting room in drug hot-spot Richmond. So should Australia launch a pill testing trial? And if so, why has it been so hard to get even a trial up and running? And would such a trial lead to increased drug use?

Testing times?

Deakin University addiction studies expert Professor Peter Miller says the problem of whether to test pills is a complex one, with opposing sides each proposing that the answer is simple and neither doing a great job of meeting in the middle.

As with safe injecting rooms and needle and syringe programs, opponents in law enforcement, government and broader society see pill testing as a great challenge, Prof. Miller explains. They genuinely don’t want people to die from overdoses, however they have concerns about how it works and whether it would encourage drug use.

'And that’s where the politicians go, "well I don’t want to be putting in place a measure where some kid thinks they’re going to be safe and then dies." And that’s where it falls over.'

Professor Peter Miller,Deakin University

Harm reduction advocates, Prof. Miller says, are passionate about trying to save lives and position when there is pill testing, no-one will die. Neither of these positions is 100% correct.

‘The reason you don’t get resolution is when you go and talk to politicians and you get such strong opposing views, without any good evidence, you end up in a policy deadlock and the politicians just put it in the too hard basket,’ Prof. Miller argues.

After safe injecting rooms, why not even a trial of pill testing?

Sydney’s safe injecting room opened in 2001. Prof. Miller says the project, which still operates, is a rare example of an extraordinary amount of courage by a few individuals [including former NSW Premier Bob Carr] in the face of pretty withering opposition.

‘They got it up, it has demonstrated its worth time and time again. We have an astounding amount of good evidence because it is there,’ he says.

And that is basically the story with pill testing, Prof. Miller argues. Young people are choosing to break the law and put themselves at risk. It is very difficult for politicians to see the benefit, particularly when you have a pretty motivated police force saying this creates a lot of problems, he says.

The problem of political risk is exacerbated when the issues contained within pill testing are closely examined. For example, Prof. Miller asks, what happens if somebody gets a pill test and then dies? Who is responsible?

‘That is one of the cruxes where most of us would say it is better than to have not tried at all – because they would have died anyway, it’s enough to have stopped the argument,’ he says.

Would pill testing lead to increased or decreased drug taking?

This question is one of the most common in the debate over pill testing. Prof. Miller says it is the wrong question to ask. Research into drug use and alcohol prices shows it is the 20% of people who are making their mind up about whether to use drugs who are the target to be influenced.

‘But if you tell them not to do something they are rebellious, so that’s why education campaigns fail or actually increase drug use … [and] that’s why Just Say No was such a catastrophic failure,’ Prof. Miller says.

The more important question to ask about pill testing, he says, is whether more people are going to be harmed or be a greater burden to others?

Prof. Miller says pill testing should in theory reduce harm to oneself, but there will always be people who don’t test their pills. The result is a situation where pill testing is always only going to be a safety net for a proportion. Pill testing is not a panacea, he says, it is not going to create a safe environment for everybody.

‘And that’s where the politicians go, “well I don’t want to be putting in place a measure where some kid thinks they’re going to be safe and then dies.” And that’s where it falls over,’ Prof Miller says.

As a scientist and somebody who wants to reduce alcohol and drug related harm in society, he argues we need to try things out to create evidence and for politicians to engage in experiments.

‘Making a mistake, doing something like this with the best of intent is better than not doing it and continuing to let kids die,’ he says.

What are the most important factors a trial would need to consider?

Prof. Miller says while there have been trials in the areas of heroin and cannabis, he is not convinced of any evidence from evaluation of pill testing. He says the most important ingredients of any potential trial are; safety as the first concern, police and government buy in, quick turn around on testing times with as many drugs as possible being covered, guidelines on the level of intoxication of those testing, and what is the protocol when a dangerous drug is found – is it handed back?

‘These are difficult questions because then people won’t necessarily go near it,’ he says. ‘This is a case where we really need people to bravely but wisely go.’

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